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Abstract
Pharmaceutical Care and Research: 2018; 18(5):337-342
DOI: DOI:10.5428/pcar20180506
Meta analysis of the relationship between methylenetetrahydrofolate reductase genetic polymorphisms and methotrexate-induced toxicities in the treatment of acute lymphoblastic leukemia in children
1. CHEN KaiJie1(1.Department of Pharmacy,First Hospital Affiliated to Xiamen University,Xiamen Fujian 361001,China cksincerely@163.com)
2. DAI ChengJia2(2.Department of Pharmacy,No.175 Hospital of PLA/Southeast Hospital Affiliated to Xiamen University,Zhangzhou Fujian 363000,China )
3. FANG GuangCui3(3.Department of Clinical Laboratory, Second Hospital of Xiamen, Xiamen Fujian 361001,China )
4. FEI Yan2(2.Department of Pharmacy,No.175 Hospital of PLA/Southeast Hospital Affiliated to Xiamen University,Zhangzhou Fujian 363000,China feiyanfy@126.com)
ABSTRACT  Objective: To evaluate the relationship between methylenetetrahydrofolate reductase(MTHFR) C677T and A1298C polymorphisms and methotrexate(MTX)-induced toxicities in children with acute lymphoblastic leukemia (ALL).Methods: All the related literature was retrieved from the databases such as the VIP China Science and Technology Journal Database,Wanfang Data Digitalization Journals, China National Knowledge Infrastructure(CNKI),PubMed and Cochrane library from the inception to March 2017.The quality of the included literature was evaluated by using the principles of STREGA.RevMan 5.0 software was applied to perform the meta analysis.Results: A total of 13 literature was included,containing 1001 patients in 13 studies related to MTHFR C677T polymorphism and 712 patients in 8 studies related to MTHFR A1298C polymorphism.The results of meta analysis showed that there were significant differences between MTHFR C677T polymorphism and overall toxicity (TT vs CC+CT:RR=1.19,95%CI 1.01-1.92,P=0.04),myelosuppression(TT vs CC:RR=1.59,95%CI 1.13-2.25,P=0.008;TT vs CC+CT:RR=1.41,95%CI 1.09-1.81,P=0.009),decreased hemoglobin(TT vs CC:RR=1.47,95%CI 1.02-2.10,P=0.04;TT vs CC+CT:RR=1.52,95%CI 1.1-2.09,P=0.01).There were also significant differences between MTHFR A1298C polymorphism and overall toxicity(AC vs AA:RR=1.73,95%CI 1.08-2.77,P=0.02;AC+CC vs AA:RR=1.83,95%CI 1.15-2.90,P=001),mucositis(AC vs AA:RR=1.71,95%CI 1.24-2.37,P=0.001;CC+AC vs AA:RR=1.51,95%CI 1.09-2.08,P=001).Conclusion: MTHFR C677T and A1298C polymorphisms were associated with MTX-induced toxicities in children with ALL.Children with MTHFR T677T genotype were susceptible to myelosuppression and decreased hemoglobin compared to those of the wild type.Children with MTHFR A1298C genotype and high dose of MTX were easy to develop mucositis compared to that of the wild type.
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Please cite this article as:
CHEN KaiJie1,DAI ChengJia2,FANG GuangCui3,FEI Yan2,. Meta analysis of the relationship between methylenetetrahydrofolate reductase genetic polymorphisms and methotrexate-induced toxicities in the treatment of acute lymphoblastic leukemia in children[J]. Pharmaceutical Care and Research / yao xue fu wu yu yan jiu. 2018; 18(5): 337-342.
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